I have a friend from college who is notorious—notorious—for ordering things from restaurants that are not on the menu. Nothing crazy. He doesn’t order shrimp cocktail at a hot-dog stand or anything. But asking for melted cheese to be spread on his burrito? Oh yeah. That’s the stuff. Turns out he’s not alone:

“That menu hacks are generally customer imposed, not instigated by the restaurants, shows in the character of the items themselves. They tend to be things that only those who don’t work in the kitchen would come up with. Such are composites of menu ingredients or entire items. At Taco Bell, one secret-menu item, known as the Incredible Hulk, consists of a five-layer burrito with guacamole instead of nacho cheese. That’s nothing but an ingredient swap.

Some well-known McDonald’s mash-ups are especially clunky. Secret-menu items such as The Pie McFlurry, a pie blended into a McFlurry shake; the McCrepe, a pancake filled with McDonald’s fruit-and-yogurt Parfait; and the McLand, Air, and Sea Burger—the innards of a burger, a chicken sandwich, and the Filet-O-Fish between the buns of one—are Frankensteinian.”

One of my co-fellows at UNC was fond of ordering pickle-less hamburgers from a McDonald’s on the West Virginia turnpike. His reasoning was that anything he special ordered would be guaranteed to be made on the spot. He didn’t like the texture of burgers that had been under the heat lamp. This seems reasonable and relatively kind to the workers at the restaurant, at least in comparison to some other tactics:

“Amid the din, once in a while, I heard a different voice. On social media, a restaurant worker would chime in, usually to counter a myth or plead for patience with or politeness to the restaurant staff. Here’s ‘Kathryn Erwin’ setting customers straight in the comments section of the ‘Nachos’ listing for Chipotle at HackTheMenu.com on December 2, 2015:

‘I work at a Chipotle and if you ask any of our crew members we will tell you that we do not have nachos. Nachos normally mean that the cheese is melted and we cannot melt the cheese for you. We can however put chips at the bottom of your bowl and then build a normal bowl for you. They are not called nachos though.’

It’s really her final line, however, that drives home the annoyance that menu hacking can bring for restaurant workers: ‘And please,’ Kathryn implores, ‘do not be rude to an employee if they refuse to call a bowl with chips nachos.’ In the conversations of menu hackers, I seldom heard such a distinctly labor point of view.”

“Few physicians achieved even the 50th percentile of satisfaction while maintaining low rates of antibiotic prescribing. To reach the top quartile, a physician had to prescribe antibiotics at least half the time; almost all physicians above the 90th percentile had a rate of antibiotic prescribing greater than 75%.”